Swelling reflects the burden of illness on a person’s body. As the illness progresses, the burden increases further, and swelling may increase as well. If the swelling is the result of fluid collecting in the abdomen, it likely can be drained by paracentesis. As the rate of accumulation increases, paracentesis may be more frequent. At late stages of the illness, paracentesis may no longer be a benefit. Like many treatments, paracentesis may present its own burden on the body.

While swelling can reflect an increasing burden of illness, the following are signs that more reliably indicate that the end of life is approaching:

• decline in energy and range of activity, from regular movement to being bedridden;
• loss of appetite and thirst and a resulting loss in weight;
• breathing becoming more irregular, and very close to death sometimes noisier;
• changes in mental state, including confusion, restlessness, withdrawal or unconsciousness.